Ricarte-Bratti Juan Pablo, Brizuela Nilda Y, Jaime-Albarran Nicolas, Montrull Hilda L
Rev Fac Cien Med Univ Nac Cordoba. 2017;74(2):99-106.
Sepsis and septic shock are clinical conditions with high mortality despite advances in technology and are the leading cause of death in intensive care. Clinical manifestations and morbidity may be attributable to a disproportionate increase in proinflammatory cytokines. The aim of this study was to evaluate the ability to predict mortality from interleukin 6 [IL-6] and matrix metalloproteinase 3 [MMP-3]. This single-center, observational, prospective study included 48 adult patients admitted to the Hospital Nacional de Clinicas in Cordoba, Argentina, with sepsis or septic shock. Serum levels of IL-6 and MMP-3 were measured at the time of diagnosis and 72 hours later. At time of admission, MMP-3 was 13.77 mg/ml in patients who died and 10.55 mg/ml in patients who survived up to 28 days after hospitalization [p = 0.012], while IL-6 did not differ between the groups. The change in IL-6 over 72 hours was increased in nonsurvivors by 21.11 ± 11.81 pg/ml and decreased in survivors by 40.87 ± 14.94 pg/ml [p = 0.007]. No difference in the change of MMP-3 over 72 hours was observed between survivors and nonsurvivors. This study shows that MMP-3 at admission and the change in IL-6 over the first 72 hours of hospitalization could provide prognostic information in septic patients. Further studies are needed to define the utility of these cytokines as a measure of sepsis severity and as predictors of mortality.
尽管技术有所进步，但脓毒症和脓毒性休克仍是临床死亡率很高的病症，是重症监护中主要的死亡原因。临床表现和发病率可能归因于促炎细胞因子的过度增加。本研究的目的是评估白细胞介素6（IL-6）和基质金属蛋白酶3（MMP-3）预测死亡率的能力。这项单中心、观察性、前瞻性研究纳入了48名入住阿根廷科尔多瓦国立临床医院的成年脓毒症或脓毒性休克患者。在诊断时和72小时后测量血清IL-6和MMP-3水平。入院时，死亡患者的MMP-3为13.77mg/ml，住院后存活至28天的患者为10.55mg/ml（p = 0.012），而两组之间的IL-6无差异。非存活者在72小时内IL-6的变化增加了21.11±11.81pg/ml，存活者则下降了40.87±14.94pg/ml（p = 0.007）。存活者和非存活者在72小时内MMP-3的变化没有差异。本研究表明，入院时的MMP-3和住院后72小时内IL-6的变化可为脓毒症患者提供预后信息。需要进一步研究来确定这些细胞因子作为脓毒症严重程度指标和死亡率预测指标的效用。
